From the Minister's Desk

DHB Elections

DHB Corner - Canterbury DHB

Regulating Medicine Advertising

Hemp Applications Approved

Major Milestone for NCSP with First of Regular Monitoring Reports

National Diabetes Research Strategy Launched

Cull Report Submissions In

Quality Improvement Strategy for Health Sector

HWAC Update

Immunise 2001: School Catch-up Programme

Copies of the Strategy

I'm pleased to report that our move toward realigning the health sector is gathering speed, with District Health Boards (DHBs) having delivered their draft district annual plans to the Ministry of Health.

Ministry staff are now in the process of reviewing the plans for 2001-2002, but there is still much work to be done in delivering this new health and disability system to the people of New Zealand.

Discussions between DHBs and the Ministry will obviously take time, but I hope that the annual plan process will be finished by the end of September.

There has been much said in recent weeks about the financial status of various DHBs, but it is simply too early to forecast figures exactly. New Zealanders will learn the true details when I make the DHBs' finalised annual plans public.

This health system is about greater transparency in decision-making and performance. The goal of every DHB is to improve the health of its populations, but this must be achieved through appropriate community consultation and the prudent and far-sighted use of taxpayers' money. Put simply, DHBs must plan wisely and then stick to their budgets.

I appreciate all the hard work that both the DHBs and Ministry staff have done so far, and I am confident the progress will continue.

I have recently had feedback from a number of people who would like to know a bit more about what is happening in the health and disability sector generally. This edition of Health Moves therefore covers a range of issues that have come to my attention recently, as well as the new 'DHB corner'.

For more detailed information on disability issues, I refer you to Participate, my colleague Hon Ruth Dyson's newsletter (details on how to receive Participate are at the back of this newsletter).

Hon Annette King
Minister of Health

Public awareness about the DHB elections is getting a boost from a national radio campaign. The first phase of advertisements, which can be heard on the Ministry of Health website (www.moh.govt.nz), feature a patient and doctor discussing the patient's prognosis about the DHB elections.

People who are interested in representing their community on health and disability issues are being encouraged to stand as candidates for the DHBs, although nominations will close tomorrow (midday on Friday 24 August).

Other radio advertising about the DHB elections is being run on 20 Mäori Media Network stations, Radio 531pi, Asian and Chinese station and other access radio stations until nominations close.

The second phase, which runs until voting ceases at noon on 13 October, will also involve radio advertising, encouraging the public to vote for who they would like to see on their local boards.

There are 21 district health boards throughout the country and each is responsible for the health of its local population. Boards fund health care services for the populations of their specific geographical area, and provide hospital and outreach services. Boards are elected by postal vote in conjunction with local body elections. Election papers go out in late September and must be in by noon on 13 October. Successful candidates take up their roles in December and are expected to serve for three years.

Anyone considering standing as a candidate or wanting to know more about the elections can visit the Ministry of Health's DHB elections web page: www.moh.govt.nz/electionsdhb or phone 0800 Participate (0800 727 842).

The Canterbury District Health Board is a 'lead DHB' in developing initiatives that aim to promote 'wellness' in the community, by encouraging hospital health professionals and community health care providers to work together to improve standards of care for the people of Canterbury.

The DHB has developed ongoing initiatives with all GP practices in its region to improve the delivery of health care. The influenza vaccination campaign is an example of such a joint initiative between the DHB, Pegasus Health, other GPs and health care providers like Age Concern. The end result has been the achievement of the highest vaccination rate for older people of any region in the country.

Such initiatives, involving a wide range of hospital, community health providers and health organisations, have helped in efforts to cope with the annual winter patient peak in Christchurch. While facilities and staff are always under pressure during this busiest period of the year, the situation is being managed appropriately.

Another joint initiative that is having obvious benefits for patients is the Elder Care Canterbury project. One of its many plans is the improvement in care for people with broken hips. This project has led to faster recovery of many patients in hospital and a speedier discharge because of increased home and community support.

Canterbury DHB chairman Syd Bradley says such joint initiatives will have great benefits for the community. "They are creating better health solutions for patients and we have an ongoing commitment to that process. However, while we are working increasingly cooperatively with primary care providers, we need to remain open minded about the results. It is too early yet to assess the impact on hospital admissions but we believe that over the long-term studies will show the outstanding value of the initiatives."

Pharmaceutical companies advertising their medicines directly to consumers will be subject to tighter controls.

Direct-to-consumer drug advertising has become increasingly common over the last five years, raising concerns among health professionals. Now, as the result of a review that began last year, Health Minister Annette King has decided such advertising should continue to be allowed, but with tighter regulation.

Mrs King said the industry would continue to self-regulate, but over the next year there would be consultation on a number of options for changes to the law.

Some changes that had been suggested include the following:

• Only allowing advertisements in broadcast and print media (drug companies are now also promoting drugs by writing to individual patients, running competitions, giving free offers and paying for doctor visits).
• Banning brand names of drugs on vehicles.
• Banning sponsorship of events using the brand name of a drug.
• Increasing fines for not complying with legislation and regulations.
• Specifying the length of time to be allocated to mandatory risk information in television advertisements, as well as the font size.
• Requiring voice-over of risk information, a mandatory requirement in the United States.

Eleven of 15 applications to cultivate industrial hemp have been approved by the Ministry of Health's Interagency Committee on the Cultivation of Industrial Hemp.

The 11 applications range in geographical area from South Canterbury to Waikato, and the area for cultivation ranges from 500 square metres to 20 hectares, with a total area for trial plantation covering 55 hectares. The crops will be grown for fibre and production of nutritional hemp seed oil.

Of the four other applications, two have been declined and two are providing further information.

The first quarterly monitoring report for the National Cervical Screening Programme (NCSP) has been released, showing a continued strong level of support for the programme from New Zealand women.

The report covers the three months from October to December 2000, and is a routine monitoring report against selected national indicators.

The report shows that there were 979,819 women aged 20-69 years enrolled on the NCSP-Register or 91.5 percent of the eligible population excluding women who have had hysterectomies. The report also shows 73.1 percent of eligible women, excluding those who have had hysterectomies, have had a smear recorded on the NCSP-Register in the past three years.

It is recommended that all women aged 20 to 69 years should have a regular smear test every three years. Cervical cancer usually takes 10-15 years to develop. Because the cells in the cervix usually change before they become cancerous, early detection of these changes through screening programmes enables early treatment.

Routine monitoring is a key factor in ensuring ongoing quality and enabling the identification and resolution of problems at an early stage. The National Screening Unit will be working with providers to the NCSP to address any issues that are identified in the monitoring reports.

The Ministry of Health and the Health Research Council have signed a joint venture agreement, each committing $250,000 for the next three years to the National Diabetes Research Strategy.

The strategy will be for clinical or community-based diabetes research, as decided by a steering committee who convened for the first time at the end of July. The first of the projects are expected to be launched by early next year.

Diabetes is a condition that is increasing globally, and indications are the prevalence of diabetes would increase significantly in the next 10 years. It causes more than 1500 deaths each year in New Zealand.

DHBs have a key role in the prevention and management of diabetes - healthy diet and exercise are critical, and effective service delivery teams can assist in preventing complications.

The Ministry of Health has received 51 submissions on the recommendations in the Helen Cull report, and these have been summarised, sent to submitters and posted on the Ministry's website shortly.

Of these 20 were from professional organisations, 13 from members of the public, and six from community organisations.

A one-stop shop, which was one of the major recommendations of the Cull report, received much comment in the submissions, although others ranged from amendments to the Health and Disability Commissioner Act 1994 and ACC legislation, to commentary on the current complaints processes.

The Government is developing a Health Sector Quality Improvement Strategy setting out the components of the high-quality public health system it wants for all New Zealanders.

Health Minister Annette King said the Government was committed to a quality health service, and determined to provide the leadership needed to attain it.

Mrs King said the Strategy would set out the building blocks that New Zealand needed to advance quality improvement activities in the health sector.

The Health Workforce Advisory Committee (HWAC), recently set up to provide independent assessment for the Minister on current health workforce issues, has appointed a permanent secretariat.

HWAC will be looking at the health workforce needed in the future to meet the objectives of the New Zealand Health Strategy and the New Zealand Disability Strategy.

A preliminary stocktake, or situation analysis, of current workforce capacity and issues and challenges for the workforce is being undertaken between August and December. The committee will seek input from a wide range of organisations and groups for this document. A vision statement will follow early next year.

Alison Hannah has been appointed to the secretariat as a senior analyst, from an extensive background in health - both clinical and Ministry of Health. Tessa Thompson has been appointed as an analyst and will start shortly. Tessa most recently worked with the Mental Health Commission.

The committee is chaired by Prof Andrew Hornblow, and deputy chaired by Karen Guilliland. The other members of the committee are: Mike Gourley, Jane Lawless, Clive Ross, Erihana Ryan, George Salmond, Margaret Southwick, Ralph Wiles and Ian Wilson.

The School Catch-up Immunisation campaign is now well under way in New Zealand schools to prevent a measles epidemic in 2002/03 and to ensure that all children have the opportunity to receive two doses of the measles, mumps and rubella (MMR) vaccine. Ministry of Health officials say the response from the community has been excellent.

"It's been more than we were expecting," Clinical Advisor David Sinclair said. "Generally we've had a positive response from the community."

The major school-based immunisation programme aims to vaccinate children between the ages of five and ten against measles, mumps and rubella as a follow-up to the vaccine they should have received at 15 months of age.

The second dose of the MMR vaccine used to be given at 11 years of age but is now given at four years by a primary health care immunisation provider.

The campaign is being run by the Public Health Nurses of each District Health Board, and will continue through the third term and into the fourth.

The Primary Health Care Strategy document is available from the Ministry of Health, c/o Wickliffe Limited, PO Box 932, Dunedin, tel (04) 496 2277, fax (03) 479 0979, e-mail moh@wickliffe.co.nz

The document is also on the Minister of Health's web site: www.executive.govt.nz/minister/king and the Ministry of Health's web site: http://www.moh.govt.nz

To respond to this newsletter, receive it, or have your name taken off the mailing list, please e-mail: healthmoves@moh.govt.nz or write to: Annette King, Minister of Health, Health Moves, Parliament Buildings, Wellington. To receive Participate, Hon Ruth Dyson's newsletter on disability issues, you can write to Ruth Dyson, Minister for Disabiltiy Issues, Parliament Buildings, Wellington, or you can e-mail: participate@moh.govt.nz.